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ABSTRACTAn ostracod assemblage from the Late Ordovician (Katian) Phu Ngu Formation of northern Vietnam, South China paleoplate, yields typical Baltic and Laurentian‐affinity genera together with some endemic forms. Detailed paleontological and sedimentary analysis of the Phu Ngu Formation suggests it was deposited in a deeper marine forearc setting, below storm wave base, but with (at least intermittently) oxygenated sea‐bottom conditions. Taphonomic assessment of the ostracod assemblage suggests it is in situ. The occurrence of globally widespread ostracod genera, including those from paleocontinents that were geographically remote from South China, is difficult to reconcile with the assumed limited dispersal capability of ostracods in shallow‐shelf settings—a characteristic that has often been used to refine Ordovician paleogeographical reconstructions. Here, we present the novel approach of using paleoclimate reconstructions to assess the environmental distributions of Paleozoic ostracod genera. We show that the deep‐marine depositional setting of our documented assemblage, together with general circulation model simulations of Ordovician ocean‐temperatures, suggests an early radiation of benthic ostracods into the deeper, colder, and thermally uniform ocean below the thermocline. The presence of a globally‐distributed psychrospheric (cool and deep marine) ostracod fauna would imply that our understanding of Ordovician ostracod dispersal is incomplete, and future paleobiogeographical studies should try to decouple the signal of shallow‐shelf benthic taxa, often endemic and probably limited by sea temperature, from those that are more cosmopolitan and tolerant of cooler, deeper waters.

• Book : 34(1)
• Pub. Date : 2025
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Breast-specific gamma imaging (BSGI) utilizes the radiopharmaceutical 99mtechnetium (99mTc) methoxyisobutylisonitrile (MIBI) and a small-field gamma scanner to detect lesions with high mitochondrial density and vascularity. In this case report, we present representative cases of true-positive, false-positive, and false-negative findings. We hope this will enhance under standing among clinicians considering the clinical application of BSGI.

• Book : 8(1)
• Pub. Date : 2025
• Page : pp.50-55
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Abstract STUDY QUESTION Do activated fibroblasts expressing fibroblast activation protein-α (FAP)—which is traceable in positron emission topography/computed topography (PET/CT)—play a role in the microenvironment of endometriosis? SUMMARY ANSWER Activated fibroblasts expressing FAP are detectable in endometriotic lesions and correlate with iron and collagen content and infiltrating CD8-positive cytotoxic T cells and CD68-positive macrophages in the microenvironment endometriotic lesions. WHAT IS KNOWN ALREADY FAP-positive activated fibroblasts are found in various fibrosis-related pathologies and in the desmoplastic stroma of solid tumors; they can be traced in PET/CT but have not been investigated in the context of endometriosis, a chronic disease involving hormone-mediated repetitive tissue remodelling and fibrosis. STUDY DESIGN, SIZE, DURATION We analysed a cohort of endometriosis patients (n = 159) who had undergone surgery with removal of endometriotic foci at our University Hospital (tertiary care center) between 2018-2024. All patients provided written informed consent. The median age of the patients was 34 years. In total, 245 samples from different locations were analysed retrospectively. PARTICIPANTS/MATERIALS, SETTING, METHODS We investigated the expression of FAP and its relation to stroma composition and the immune microenvironment of endometriosis in 245 specimens from peritoneal lesions, ovarian endometriomas, deep infiltrating endometriosis and extra-abdominal lesions using conventional histology and immunohistochemistry followed by digital image analysis. Tissue within a radius of 500 µm of ectopic endometrium-like epithelium was analysed. To measure FAP expression in the perilesional stroma, a histoscore (H-score) was calculated. Masson trichrome staining was used to determine collagen content. Prussian blue staining for iron was used for age-dating of lesions. The abundance of CD68-positive macrophages and CD8-positive cytotoxic T cells within the microenvironment of ectopic endometriotic glands was analysed. Extra-lesional tissue served as controls. MAIN RESULTS AND THE ROLE OF CHANCE Distinct FAP expression (H-score > 10) was observed in 84% of endometriotic lesions and in only 4% of extra-lesional controls. FAP expression was significantly higher in endometriotic lesions (mean H-score of 61.8) than in extra-lesional tissue (mean H-score 3.8, p < 0.0001). There was a significant (p < 0.05) association with collagen content when comparing samples with low (H-score < 100) and high (H-score ≥ 100) FAP expression, and a significant difference in FAP expression correlating with the tissue iron content when comparing strong staining intensity and negative samples (p < 0.0005) or samples with weak staining intensity (p < 0.005). Moreover, the abundance of CD8+ and CD68+ cells was significantly higher (p < 0.0001) in samples with high FAP expression (H-score ≥ 100). LARGE SCALE DATA The data underlying this article will be shared upon reasonable request to the corresponding author. LIMITATIONS, REASONS FOR CAUTION This study proves the presence of FAP-positive fibroblasts in endometriosis by immunohistological methods. However, to translate targeting FAP into endometriosis diagnostics, these results have to be compared to imaging data and FAP inhibitor (FAPi) PET/CT has to be validated in a structured way on a large patient cohort. Moreover, we show that FAP expression is intertwined with the immune cell infiltrate in the microenvironment of endometriosis. To explore and to understand mechanisms contributing to chronic inflammation, immune evasion and fibrosis, more studies including more immune cell subtypes and functional experiments, are needed. WIDER IMPLICATIONS OF THE FINDINGS FAP-positive activated fibroblasts not only impact the immune microenvironment of endometriosis and are linked to increased macrophage and cytotoxic T cell infiltration, as we showed, but could also provide new options for non-invasive diagnostic methods and an improvement of the diagnostic workup prior to surgery. FAPi PET/CT should be considered when exploring new diagnostic options in endometriosis. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) “Clinician Scientist Program in Evolutionary Medicine” (project number 413490537 to FK). The authors declare that they have no conflicts of interest.

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